Parkinsonism caused by adverse drug reactions: a case series

<p>Abstract</p> <p>Introduction</p> <p>Parkinsonism puts a high direct cost burden on both patient and caregiver. Several reports of drug-induced parkinsonism have been published, but to the best of our knowledge, there has not been any report of quinine or halothane inducing parkinsonism.</p> <p>Case presentation</p> <p>We describe two cases of parkinsonism possibly caused by adverse drug reaction to quinine in a 29-year-old black Nigerian woman and to halothane in a 36-year-old black Hausa (Nigerian) man who received it as general anaesthesia for appendicectomy in our teaching hospital.</p> <p>Conclusion</p> <p>These are two unusual cases of parkinsonism caused by adverse drug reactions to high-dose quinine and to halothane as general anaesthesia. We consider that these two cases are important in bringing this potential side-effect to the attention of both pharmacologists and primary care physicians as these are two of the most commonly used medications in our clinics. We conclude that parkinsonism should be included among the adverse drug reactions to high-dose quinine and halothane general anaesthetic.</p

Focal EEG Findings in Juvenile Absence Syndrome and the Effect of Antiepileptic Drugs

The presence of focal EEG abnormalities in juvenile absence syndrome (JAS) may cause it to be misdiagnosed as focal epilepsy. The purpose of our study was to determine the presence of focal EEG abnormalities in patients with JAS and to ascertain whether some clinical features or antiepileptic drugs (AEDs) have an effect on focality. Serial EEGs of 52 consecutive patients with JAS were retrospectively analyzed. The patients were divided into two groups according to whether they were treated with valproic acid and/or lamotrigine (VA-LTG) or not during the times of these EEG recordings. The relationship between the presence of EEG focality and the use of AEDs in addition to other risk factors was examined. Two or three consecutive EEGs (total 100) of the 52 patients were evaluated. Among these, the rates of focal EEG abnormalities were 18%, 36%, and 25% during the follow-up EEGs without AEDs (5/27) and first (16/45) and second EEGs (7/28) with AEDs, respectively. The last two EEGs showed a tendency towards a higher proportion of EEG focality in patients who received other AEDs (47%-45%) compared with those that received VA-LTG (13%-12%). The proportion of JAS patients with focal EEG findings in serial EEGs tended to decrease with an increasing rate of VA-LTG use. As a hypothetical explanation, changes in EEG focality may reflect the effect of AEDs other than VA and/or LTG, in addition to a developing hyperexcitable cortical area